KATHRYN MARIE DOMINICK DO
NPI 1437640901
Obstetrics & Gynecology in Shiloh, IL

Active since May 21, 2018PECOS EnrolledAccepts Medicare Assignment
72.82/100
CMS Quality Rating
1170 FORTUNE BLVD, SHILOH, IL 62269(618) 997-5266(618) 997-5285 Get Directions Write a Review

NPPES record last updated: March 2, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 2, 2023, Feb 8, 2019, May 21, 2018 (3 updates tracked since 2018).

About Kathryn Marie Dominick Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHRYN MARIE DOMINICK DO (NPI 1437640901) is an individual obstetrics & gynecology provider in Shiloh, Illinois, licensed in Illinois (036161559) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and maintains a secondary practice location in Kalamazoo.

NPPES Registry Identity

NPI1437640901
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameKATHRYN MARIE DOMINICKCredential: DO
Location Address1170 FORTUNE BLVDShiloh, IL 62269-7358
Mailing Address1000 Oakland DrKalamazoo, MI 49008-1282
Fax(618) 997-5285
Sole ProprietorNo
Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 2018
Enumeration DateMay 21, 2018
Last NPPES UpdateMarch 2, 20233 updates tracked since enumeration
NPPES CertifiedMarch 2, 2023
NPI 1437640901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License Licensed in IL · 036161559
Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 5151011654 (MI)
1170 FORTUNE BLVD, Shiloh, IL 62269

Secondary Practice Location 1

Location 11000 Oakland DrKalamazoo, MI 49008-1282 · Phone (269) 337-4472 · Fax (269) 337-4234

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kathryn Marie Dominick Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890050470
PECOS Enrollment IDI20220918000015
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
36 services36 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
29 services24 patients
Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
17 services17 patients
Detection test by nucleic acid for human papillomavirus (hpv), high-risk types 87624
This test detects high-risk types of HPV, a common virus. It's done by analyzing a small sample of cells for the presence of HPV DNA. The aim is to identify any high-risk types early, as they may increase the risk of certain health issues.
15 services15 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
15 services15 patients
Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina 76830
An ultrasound scan of the lower abdominal region is a safe, non-invasive procedure that uses sound waves to create images of internal structures. This helps in checking the health of reproductive organs and detecting any abnormalities. The scan is done via a small probe inserted into the body.
14 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital

Acute Care Hospitals · Belleville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140185
Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County
Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140187
LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62269 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$131.14 typical visit price
range $56.28 – $173.35
Typical copayment $32.78 (range $14.07 – $43.33)
Most-billed visit code 99204
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

72.82/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.15
Improvement Activities40
Cost27.75

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1170 FORTUNE BLVD
SHILOH, IL 62269
Obstetrics & Gynecology (Obstetrics)
1170 FORTUNE BLVD
SHILOH, IL 62269
Advanced Practice Midwife
1170 FORTUNE BLVD
SHILOH, IL 62269
Obstetrics & Gynecology
1170 FORTUNE BLVD
SHILOH, IL 62269
Obstetrics & Gynecology
1170 FORTUNE BLVD
SHILOH, IL 62269
Advanced Practice Midwife
1170 FORTUNE BLVD
SHILOH, IL 62269
Nurse Practitioner (Family)
1170 FORTUNE BLVD
SHILOH, IL 62269
Nurse Practitioner (Women's Health)
1170 FORTUNE BLVD
SHILOH, IL 62269

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathryn Dominick's NPI number?

The NPI number for Kathryn Dominick is 1437640901. It was assigned to this individual provider in the NPPES registry on May 21, 2018.

Where is Kathryn Dominick located?

Kathryn Dominick practices at 1170 Fortune Blvd, Shiloh, IL 62269. The listed phone number is (618) 997-5266.

What is Kathryn Dominick's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kathryn Dominick enrolled in Medicare?

Yes. Kathryn Dominick is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kathryn Dominick accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and UnitedHealthcare list Kathryn Dominick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kathryn Dominick affiliated with any hospitals?

According to CMS data, Kathryn Dominick is affiliated with Memorial Hospital and Hshs St Elizabeth's Hospital.

When was this NPI record last updated?

The NPPES record for Kathryn Dominick was last updated on March 2, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.